Kidney Dialysis Service: Experiences of Consumer and Provider and Quality of Life of End Stage Kidney Disease Patients in Parbat, Nepal

Abstract

Background/Objectives The kidney dialysis patients and service providers possess a wide range of experience relating to the service, and quality of life is an important measure to evaluate holistic approach to chronic disease management such as kidney disease. This study was conducted to find out the experience of kidney dialysis patients and service providers and quality of life of end stage kidney disease patients.

Methods A qualitative study was conducted, from March 2024 to August 2024, among 20 end stage kidney disease patients visiting Parbat hospital for dialysis and 7 dialysis service providers, doctor and nurses, using in-depth interview guidelines, kidney disease quality of life-36 instrument (for end stage kidney disease patients) and job satisfaction survey tool (for service providers). Thematic analysis was performed from the transcribed and translated recorded information to carry out the actual theme.

Result Nine (9) themes were extracted for experiences of kidney dialysis patients. They were (i) perception on end-stage kidney disease, (ii) perception on free kidney dialysis service at the hospital, (iii) administrative process for free dialysis service, (iv) feasibility with the schedules of dialysis session, (v) quality of care and response of service providers (vi) duration of dialysis session (vii) desires and challenges towards kidney transplantation, (viii) on recommending the dialysis site and (ix) further expectations for improvement. The quality of life of end-stage kidney disease patients was found to be moderate. Similarly, nine (9) themes were extracted for experiences of service providers. They were (i) patient personalized care and understanding patients’ behavior (ii) addressing queries and concerns of the patients (iii) rewarding aspect of the job (iv) learning acceptance and witnessing positivity (v) availability of safety measures and protective protocols (vi) training and professional development experience (vii) reflection on job security (viii) challenging aspect of the job (ix) further expectations and requests. The kidney dialysis service providers were found to be ambivalent, neither satisfied nor dissatisfied with the job.

Conclusion Patients share an overall good experience of free kidney dialysis service at Parbat hospital while the service providers also have a positive experience working in the dialysis section. However, expectations for provision of free medications and availability of nephrologist by the end stage kidney disease patients direct towards the reforms for improved service delivery. The doctor and nurses should be provided with more opportunities for professional development and safety should be a priority. These respective vigilance and actions for, shall address the quality of life and job satisfaction as well.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical Review Board of Nepal Health Research Council (NHRC) gave ethical approval for this study. The approval reference number is 179.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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